David Melbourne has been a chief finance officer (CFO) in the NHS for more than 20 years. David is currently Deputy Chief Executive/Chief Finance Officer at Birmingham Women’s and Children’s NHS Foundation Trust, responsible for areas including IT and informatics, performance, transformation, fundraising, corporate governance, estates and the trust’s subsidiary company, BWC Management Services Ltd.
David gained a first class degree in economics at Leicester University and completed an MBA at Warwick University before qualifying as a chartered accountant and chartered public accountant. He started his career on a training scheme as an auditor with a local health authority in Leicester, where he gained his CIPFA qualification in 1987/88.
David then moved into management consultancy with KPMG, working largely in the local government, higher education and healthcare sectors. After five years with the firm, David decided to join the NHS, and took on the role as CFO for a north Derbyshire Primary Care Trust (PCT).
David gained experience in Director of Finance roles in Derbyshire and Lincolnshire before moving to Heart of Birmingham Teaching PCT, where he was appointed Director of Resources and Deputy Chief Executive in 2005. David first joined Birmingham Children’s Hospital NHS Foundation Trust in 2009 as CFO, with his current role resulting from its merger with the Birmingham Women’s NHS Foundation Trust in 2017.
David has also helped establish a social enterprise in Birmingham – the Health Exchange – that provides health promotion advice to disadvantaged and hard to reach communities. David received the NHS Finance Director of the Year award in December 2011 from the Healthcare Financial Management Association.
When did you first become attracted to a career in the public sector, and particularly public finance?
I’ve always been involved in local politics, and I’ve always been really interested in politics and economics. I grew up in north east Derbyshire, and my dad was a miner; we lived through the experience of the miners’ strike, after which he was made redundant. My degree was in economics, and I’ve always been interested in resource use in the public sector.
These two strands came together in my career within the context of how you make resource decisions for the public good. You feel you’re making a contribution to society – albeit at times in my career I’ve felt that the public sector has tried to follow the private sector too much and, at times, forgotten what’s good about it. That’s one of the great things about CIPFA – it does keep you focused on those values.
What have been the highlights or biggest successes of your career to date?
There are so many. I won the NHS Finance Director of the Year Award in 2011, which recognised the contribution I had made, which was very rewarding.
From a service perspective, the merger of the Birmingham Children’s Hospital NHS Foundation Trust and the Birmingham Women’s NHS Foundation Trust in 2017, stands out because I genuinely feel that it gives us a platform to improve services for the local population.
Also, the development of a new £35 million facility on our site, which I’ve overseen, has been an important step for us. And the work that I’m doing with the local maternity system – I’m the senior responsible officer, and that really keeps you close to the reasons we are here, and the issues women face when they’re going through pregnancy. It’s not what an accountant normally gets into.
What have been the greatest challenges during your career and within the public finance sector as a whole?
The frustration in the public sector is always around how you develop partnerships and get organisations to work together to better provide high quality services for citizens and patients. That continues in to be a major issue in the NHS.
It comes partly from the way the public sector is funded down different channels, as well as a focus within many organisations on their own particular interests, structures and operations. That is a big challenge for every leader in public sector finance.
I think in the NHS the move towards integrated care systems could really help us focus on disruptive innovation. There’s a book by the late Harvard professor Clayton M Christensen called The Innovator's Prescription: A Disruptive Solution for Health, in which he argues that you need to break down these barriers if you’re truly going to innovate in healthcare.
What’s the best piece of advice you’ve given? And by whom?
'Always stay true to your values, do the right thing all the time, even if it’s uncomfortable’. That was from a partner at KPMG when I left the company to join the NHS. And it’s been a valuable piece of advice.
What book/film/podcast would you recommend to anyone working in public finance?
The book would be Hard Work: Life in Low Pay Britain by Polly Toynbee. In the early 2000’s she tried to live on the minimum wage and worked in hospitals in London as a porter and in other low-paid roles, which she discusses and shines a light on. It cements everything I believe in about what’s right and wrong in public services. The film would be the The Grapes of Wrath, based on the brilliant John Steinbeck novel and directed by John Ford, which I just love. I’ve seen it many times. I first saw it during the miners’ strike and it really resonated with me.
What would you say to somebody thinking of becoming a CIPFA member?
CIPFA is a great institution, and it does give you a very good foundation in the public services.
Qualifying as an accountant is really important because the contribution you can make to public services and the use of resources is going to be absolutely key, particularly over the next five years [to 2025]. That includes showing how we can add value beyond just being bean counters, how we can deliver value-based accounting, and how we can deliver the best outcomes possible in healthcare. All these require our numeracy and financial skills. It’s a great career.